The Personal Treatment – Healthcare And CRISPR

Faster, more accurate diagnoses and potentially better treatment – but at what risk?

The personalisation of products and services is becoming big business in several market sectors. From clothing and cosmetics, to food and finance, personalisation responds to the needs and demands of individual consumers. Nowhere is this more important than in healthcare, where the personalisation of treatment not only provides an improved patient experience, but can also be a matter of life and death.

Your body, your needs

We are slowly moving away from a one size fits all approach to healthcare. Thanks to developments in technology and progress in our understanding of the body, it is becoming possible to create drugs and treatment programmes tailored to the needs of individual patients. This is a serious upgrade to the domain of medicine, and it is happening now.

After ten years of research, InSilixa, a biotech company based in California, has developed a biochip capable of identifying different microbes in the body in a matter of hours. The disposable silicon chip analyses samples such as cheek swabs and blood draws to isolate genetic material and compare it to known pathogens. This gives doctors a quick and reliable method of diagnosing infectious diseases. It is a significant improvement on standard test methods, where sample microbes must be grown in a lab over a few days or weeks before they can be identified. With accurate insight into the precise pathogens afflicting a patient, healthcare professionals can target microbes with specific drugs. This not only improves outcomes for the individual, but will help to reduce antibiotic resistance in the wider population – a matter of critical current importance.

Medicine is better with CRISPR

It would be impossible to discuss personalised healthcare without mentioning the gene editing technique CRISPR. Since the human genome was fully sequenced for the first time in 2003, it is now possible to make changes to our DNA in order to treat certain diseases. CRISPR is the fastest, most versatile and precise method of genetic manipulation currently available, and it works by removing, adding or altering sections of DNA.

The application of CRISPR to patients in the West has so far been stalled by ethical concerns and stringent regulation, although the University of Pennsylvania has been given clearance to begin the US’s first trial on human patients, which is expected to start this year. In contrast, China has been using the technique on cancer and HIV patients since 2015, with at least 86 individuals having undergone gene editing treatment.

The ethical debate surrounding the use of CRISPR is right and proper given that it is a technology which enables us to permanently change our genetic makeup. However, the potential to revolutionise the fight against aggressive diseases will make it increasingly difficult for authorities to suppress its use in the long term.

Just because we can, doesn’t mean we necessarily should

Along with applying an understanding of our genetic material to the treatment of disease, it is also now possible for the everyday person to have their DNA analysed cheaply and easily. Consumer focused DNA analysis companies such as 23andMe offer genetic profiling for ancestry and health purposes for around £50 – £100. This gives individuals the opportunity to find out more about their global ancestry and DNA heritage, and can also highlight potential risk markers for disease.

On the face of it, this sounds like good news. Who wouldn’t want an insight into health conditions which might affect them in the future, so that they can be alert to symptoms and seek treatment as soon as they arise? Well, whilst many people view the discovery of their genetic makeup as a bit of a novelty, it can throw up worrying markers for extremely rare diseases.

In a 2017 trial in the US, adults had their genomes sequenced to see if this could improve the provision of primary care. Interestingly, the DNA of several patients in the trial suggested that they should have certain genetic diseases – when they were actually perfectly healthy. This raises the question of whether genome sequencing brings undue worry to patients who might never go on to develop those diseases for which they are supposedly at risk. The healthcare industry will also have to take into account the potential benefits of genome analysis when compared to its financial cost. With genetic profiling likely to become cheaper as technology advances, however, it is sure to be a feature of our primary healthcare at some point in the future. Familiarity with your genetic makeup could soon be as commonplace as knowing your name, age and home address.

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